Nicotine replacement products and addiction

Most medical sources tell us that one of the most addictive substances in cigarettes is nicotine. Nicotine Replacement Therapy (NRT) products like gum, patches, inhalers, lozenges and sprays are intended to help you stop smoking by getting nicotine into your bloodstream without the need for smoking. The idea is that this reduces the nicotine cravings or withdrawal symptoms that many people experience when they quit smoking and allows them to gradually cut down the dosage. Many people have found it useful alone or combined with other therapies like hypnotherapy.

Coming off nicotine gum, patches or lozenges

Health Authorities in most countries recommend Nicotine Replacement products should be used over a period of no longer than twelve weeks. A few have recently extended this to up to six months. However, around one in twenty people stop smoking but find it hard to come off NRT at all. (source: http://www.patient.co.uk/health/nicotine-replacement-therapy)

On a discussion on Radio Two in August 2013, people phoned in who had been using nicotine patches, gum or lozenges for as long as fifteen years. I have personally worked with people who have been using them for as long as ten years.

A quick search of the Internet will show you that some people argue this is a psychological issue - in effect a habit, or perhaps an underlying belief that you are not able to do without nicotine altogether. Others say it is a physical addiction and is simply continuing your dependence on nicotine.

Are nicotine replacement products dangerous?

K. Michael Cummings, Chair of the Department of Health Behavior at the Roswell Park Cancer Institute said in an interview. "You're better off chewing gum or wearing a patch than smoking."

However, even if the long-term use of nicotine replacement is less damaging to your health than smoking, few studies have been carried out on the effects of their long-term use. At least one of these few showed that nicotine was associated with "insulin resistance, metabolic abnormalities associated with the insulin resistance syndrome, and increased cardiovascular morbidity" andsuggested that long-term use of NRT products should be avoided.

Some studies have also indicated that long-term use of NRT may activate a gene called FOXM1 which can increase the possibility of mouth cancer, although this research is as yet very new and has only been carried out on a very small scale. Other factors may well be at work. Dr Muy-Tech Teh, who led the new research, said: "Smoking is of course far more dangerous, and people who are using nicotine replacement to give up should continue to use it and consult their GPs if they are concerned. The important message is not to over-use it, and to follow advice on the packet." ( click for source)

In conclusion, it seems from this that you do reduce risks to your health by using NRT instead of smoking. These products are safe over the short term, which is what they were designed for. We simply don't have enough information to draw any conclusions about their long-term use. Until we do, ideally you should quit the nicotine gum or patches once you are over your smoking habit.

The ecig question

There are also periodic concerns expressed over the safety of ecigs, such as the report (here) made to the European Respiratory Society's Annual Congress in 2012 in Vienna which suggested that vaping for only ten minutes can affect your airway resistance (efficiency of breathing). This again was a small scale study and medics are quite rightly reluctant to draw specific conclusions from it, but it does highlight another area needing further study. A more recent study (2015) carried out by Public Health England was more positive, concluding that ecigs were 95% safer than cigarettes and may be contributing to the falling number of smokers. (source)

Either way, it's clear that while ecigs may be less harmful than traditional cigarettes, the least harmful route of all is not to use either.

Can hypnotherapy help me quit ecigs or NRT?

I couldn't find any studies which address this specific question and I suspect the area is simply too new for any to have been done. However, there is quite a bit of evidence that shows that if you really want to stop smoking hypnotherapy can help. Some examples of this are here.

Hypnotherapy can also help you change habits. As long ago as 1955, the Psychological Medicine Group of the BMA commissioned a Subcommittee, led by Prof. T. Ferguson Rodger, which concluded that in the opinion of the Subcommittee:

it [hypnotherapy] has proved its ability to remove symptoms and to alter morbid habits of thought and behaviour (click for source)

So whether you believe that your long-term use of ecigs, nicotine patches, gum, inhalers or other NRT products is a 'habit of thought or behaviour' or a continuation of your smoking addiction it seems reasonable to conclude that if you are ready to stop using them, hypnotherapy could very well provide the support you need.

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